Ratings for the Second Population and AIDS Project for Chad were as follows: outcomes were moderately unsatisfactory; risk to development outcome was substantial; Bank performance was moderately unsatisfactory and borrower performance was also moderately satisfactory.
... See More + Some lessons learned includes: while the Bank can be instrumental in stimulating Government commitment for both HIV/AIDS and population, commitment is perhaps more easily sustained for HIV/AIDS than for population. The advantages and disadvantages of building on previous projects need to be carefully examined during project preparation. While the introduction of the mobile health teams and the Result-based Financing (RBF) contradicted this lesson, this was justified by the fact that when the existing delivery of services is so poor and the need for services so great, important risks are warranted, even without adequate feasibility studies. For the follow-on project, more 'due diligence' is in progress to assess accurately the risks of the operation with a view to build stronger government ownership. The importance of efficiency as a criterion for assessing health and social development projects must be seen in a broader context. There is no substitute for timely baseline data and an operational Monitoring and Evaluation (M&E) system.
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The development objective of the Additional Financing for the Second Population and AIDS Project is to contribute to changing the behavior of the Chadian populations so that they will adopt behaviors which will reduce the risk of: (i) HIV infection; and (ii) too closely spaced and/or unwanted pregnancies.
... See More + The additional financing will extend the new integrated and decentralized approach to HIV/AIDS and maternal and child health services in ten health districts in five regions, in addition to the capital city, Ndjamena. This approach decentralizes oversight to local governments, involves community-based organization in service delivery, and expands the use of mobile teams to reach isolated villages. It will also introduce a results-based financing (RBF) approach to improve maternal and child health outcomes that will be piloted in two additional regions. Lastly, the additional financing will strengthen monitoring and evaluation, including data collection, analysis, and the use of national household based surveys, and medical waste management.
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The objective of the project, which would remain unchanged, is to contribute to behavior change among the population of Chad in order to reduce the risk of both HIV infection and too closely spaced and / or unwanted pregnancies.
... See More + The environmental management document aims at addressing appropriate mitigation and management measures to minimize impacts that may develop during the implementation of the project. Suggested mitigation measures include : develop training programs for personnel responsible for health and security outreach issues among project affected peoples (PAPs), transport of liquid and solid waste, maintenance of medical equipments, emergency and rapid response, control of emissions, and protection of equipment and hygienic; prepare text and norms for the implementation of the dechets biomedicaux (DBM); infectious waste, such as : sharps, chemical and pharmaceuticals, used containers, broken thermometers will be disposed to an incinerator or treated before sent to waste disposal site; waste water from hospitals, health centers' toilets and bathrooms will be treated prior to discharged in to ground or natural drains; organize community outreach and public awareness campaigns to keep them inform throughout all stage of project implementation; follow the norms of environmental and medical / hospital best practices prepared by the Ministry of Health, particularly during vaccination campaigns and everyday shots / injections given at hospital and clinics; and finally, in general, adhere to Chad's legislation, codes of public health, and international conventions relative to health services (WHO / OMS, UNICEF) of which Chad is a signatory, and the Bank's health, nutrition and population, environmental and social operational safeguards directives.
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The Second Population and AIDS Project will seek to contribute to changing the behavior of the Chadian populations so that they will adopt behaviors which will reduce the risk: a) of infection from the HIV, and b) of too closely spaced and/or unwanted pregnancies.
... See More + The project consists of five components: 1) This component will strengthen the capacities of the six key ministries most likely to have an impact on the evolution of the HIV/AIDS epidemic. 2) This component will support strengthening of the two subcomponents of the Fond de Soutien aux Activites de Population (FOSAP), namely: the grants and micro-credits to provide support to associations and nongovernmental organizations intervening in the areas of HIV/AIDS prevention and education and population. 3) This component will support the existing program of social marketing (MASOCOT): a) the ongoing marketing of condoms and rehydration salts; and b) expansion of the program to new products such as impregnated bed nets that would have an impact on child mortality and morbidity and oral contraceptives. 4) This component will provide support to the implementation of the declaration of population policy. Specifically this component will help the Division of Population to reinforce its managerial capabilities; mainstream Information, Education and Communication and Behavior Change Communication interventions; and disseminate results of operational research in population. 5) This component will support project management.
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